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Greater remission rates in patients with early versus long-standing disease in biologic-naive rheumatoid arthritis patients treated with abatacept: a post hoc analysis of randomized clinical trial data
Y. Yazici, D. Moniz Reed, C. Klem, L. Rosenblatt, G Wu, J.M. Kremer
CER3823
2011 Vol.29, N°3
PI 0494, PF 0499
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PMID: 21722499 [PubMed]
Received: 29/04/2010
Accepted : 26/01/2011
In Press: 29/06/2011
Published: 29/06/2011
Abstract
OBJECTIVES:
Current aim of rheumatoid arthritis (RA) reatment is to achieve remission in as many patients as possible. Rates of remission and clinical outcomes after treatment with abatacept in biologic-naive rheumatoid arthritis (RA) patients with early disease and an inadequate response to methotrexate (MTX) versus patients with ≥10 years of disease were assessed.
METHODS:
Data from two trials assessing the efficacy of abatacept in MTX inadequate responders were pooled for this exploratory post hoc analysis. Patients with disease duration of ≤2 years at baseline (early disease), originally assigned to an abatacept ≈10 mg/kg treatment arm and entered into a long-term extension (LTE), were compared with patients with ≥10 years of disease (long-standing RA). Remission, DAS28-CRP, ACR 70 responses and the Routine Assessment of Patient Index Data 3 (RAPID3), improvement in physical function as measured by the Health Assessment Questionnaire Disability Index (HAQ-DI).
RESULTS:
Twenty-three percent of these patients (n=108) had early disease. A higher percentage of patients with early disease achieved DAS28-CRP remission versus patients with long-standing disease (35.2% vs. 19.4% at year 1, p<0.01; 46.0% vs. 30.9% at year 3, p<0.05). In addition, a higher percentage of the subgroup with early RA achieved ACR70 responses. More patients with early RA had a meaningful improvement in their HAQ-DI (75.2% vs. 60.4%; p<0.05) and RAPID3 scores at one year (mean changes from baseline of -9.6 vs. -8.1; p=0.009).
CONCLUSIONS:
These data provide additional support for the possible use of abatacept in biologic-naive patients who have had inadequate response to MTX, earlier in their disease course.